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Abstract: TH-PO412

Lipid Level and Its Impact on Cardiovascular Mortality in Peritoneal Dialysis Patients

Session Information

Category: Dialysis

  • 703 Dialysis: Peritoneal Dialysis

Authors

  • Lee, Yong kyu, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
  • Streja, Elani, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
  • Moradi, Hamid, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
  • Kalantar-Zadeh, Kamyar, Harold Simmons Center for Kidney Disease Research and Epidemiology, Division of Nephrology and Hypertension, University of California, Irvine, Orange, California, United States
Background

Peritoneal dialysis (PD) patients show different characteristics in terms of lipid profile and qualitative function compared to hemodialysis (HD) patients, however there are limited large-scale studies regarding the influence of lipid level on cardiovascular mortality in PD patients. The guideline for lipid control, which is focused on cardiovascular mortality in HD patients, needs validation with respect to its application in PD patients.

Methods

7,543 PD patients were selected from a national cohort of patients treated by a large dialysis organization during 2007-2011. We sought to verify the relationship between lipid levels—including total cholesterol, LDL cholesterol, and triglyceride levels—and cardiovascular mortality. Lipid levels were divided into 6 strata and 3 different hierarchical adjustment models were applied to observe the change in relationship after adjustment.

Results

Total cholesterol, LDL cholesterol, and triglyceride showed a consistent trend, whereby patients in the lowest stratum were observed to have highest cardiovascular mortality: hazard ratios were 2.183 (1.634-2.916), 1.513 (1.166-1.963), and 1.788 (1.348-2.373), respectively in case-mix adjusted models. Cardiovascular mortality risk showed a reversed J-shaped association with inflection at a total cholesterol level of 200-230mg/dL, LDL cholesterol level of 100-120mg/dL, and triglyceride level of 200-250mg/dL.

Conclusion

In contrast to conventional belief, PD patients with low total cholesterol, LDL cholesterol, and triglyceride levels showed higher cardiovascular mortality.

Funding

  • NIDDK Support